Abstract: :
Purpose: The aim of the study was to identify predisposing factorsand to define clinical and microbiological characteristics ofbacterial keratitis in our current practice. Methods: A retrospectiveanalysis of the hospital records of patients presenting withbacterial keratitis and treated at the Quinze-Vingts NationalCenter of Ophthalmology, Paris, France, was performed duringa 20 month period. A bacterial keratitis was defined as a suppurativecorneal infiltrate and overlying epithelial defect associatedwith presence of bacteria on corneal scraping and/or that wascured with antibiotic therapy. Risk factors, clinical and microbiologicaldata were collected. Results: 300 cases (291 patients) of presumedbacterial keratitis were included. Potential predisposing factors,usually multiple, were identified in 90.6% of cases. Contact-lenswear was the main risk factor (50,3%). Trauma or a history ofkeratopathy was found in 15% and 21% of cases respectively.An organism was identified in 201 eyes (68%). Eighty-three percentof the infections involved gram-positive bacteria, 17% involvedgram-negative bacteria, and 2% were polymicrobial. Gram-negativebacteria were associated with severe anterior chamber inflammation(p=0.004), as well as greater surface of infiltrates (p=0.01).Ninety-nine percent of ulcers resolved with therapy, but only60% of patients had visual acuity better than the level at admission,and 5% had very poor visual outcome. Conclusions: Contact lenswear is the most important risk factor. Most community-acquiredbacterial ulcers resolve with appropriate treatment.